Dental Implant Surgery

Having dental implant surgery requires a commitment from both the implant specialist and the patient, as dental implant placement can take anywhere from a few weeks to several months, depending on the number of teeth being restored and the type of implant surgery performed. Dr. Greenbaum’s expertise in implantology allows him to determine the best approach and follow your progress from the initial consultation to the placement of your permanent restorations.

The surgery takes 30-60 minutes for one implant and anywhere from 2 to 3 hours for multiple implants. Before surgery, the area is numbed with a local anesthetic. You may also receive antibiotics. Nitrous oxide can be used to promote relaxation and comfort.

A small incision is made in the gums at the implant site, revealing the bone. Your doctor carefully places the titanium implant, which resembles a screw, into the jawbone. Depending on the type of implant and your overall health, the top of the implant may or may not be covered by gum tissue to allow healing.

In some instances, dental crowns or an arch of replacement teeth can be attached immediately. However, most patients need 3-4 months for the implants to fully fuse with the surrounding jawbone and provide a stable base for replacement teeth. If you have periodontal disease or a gum infection, immediate placement is not recommended. Our doctors carefully weigh the benefits of immediate placement against the risks to determine what is best for you.

A depiction of the upper jaw with all normal teeth
1. Normal
A representation of the healed jaw bone after placement of the dental implant
4. Implant Placed
An example of the upper jaw missing a tooth with the jaw bone unhealed
2. Tooth Loss
A representation of the healed jaw bone after placement of the dental implant
5. Healing
A representation of a healed upper jaw bone after loosing a tooth
3. Healed Bone
An example of a fully restored tooth using a dental implant
6. Implant Restored

Bone Grafting for Dental Implant Surgery

If your teeth have been missing for some time, you may not have sufficient jawbone support for dental implants. Over time, the jawbone thins and shrinks when teeth are missing because the roots of the teeth no longer stimulate healthy bone growth. If you have extensive bone loss, you may require bone graft surgery to build up the area and provide strong, stable support for the dental implants. The bone grafts provide a scaffold for new jawbone growth sufficient to support dental implants.

Healing After Dental Implant Surgery

Once the titanium implants are surgically placed, the healing process begins. The length of time varies from person to person, depending upon the quality and quantity of bone. Most patients need at least six weeks for successful osseointegration. During osseointegration, the jawbone fuses with the implant, creating an integrated replacement root capable of supporting your new dental crown or arch of replacement teeth. After the area has healed sufficiently, your surgeon attaches the restorations to the implants with an abutment (a thin post inserted into the center of the implant screw). Occasionally, the restorations may be placed on the same day. If the implants were covered during placement, they are uncovered, and the gum tissue is given time to heal, which typically takes two weeks.

Impressions of the mouth are taken either when the implants are placed or when the swelling has subsided and the implants are fully osseointegrated. Our doctors use iTero digital impression system to design and create your dental crowns or replacement dentures. This allows greater precision while eliminating traditional dental impressions’ mess, discomfort, and suffocating feelings. No more gagging, greater accuracy, and faster results are all benefits of the iTero system.

After the restorations are attached to your dental implants, we may recommend a soft tissue graft to improve the appearance of the gum line around the base of the restorations. Gum tissue is removed from one area of the mouth and attached to the gums around the implant. This results in a more natural appearance and allows for easier cleaning. Gum grafting is a brief, simple procedure causing minimal discomfort.

Missing Teeth? Consider Dental Implants!

We are accepting New Patients and always look forward to helping you with all your dental needs.

For more information about Dental Implants or to schedule a consultation with Dr. Greenbaum,

Call our Bethesda MD office at (301) 530-3600 or

Schedule an Appointment

Dental Implant Surgery FAQs

What can I use for my teeth before the final restorations?

During the healing process, we provide temporary restorations. You leave our office with a full set of temporary teeth so that you can carry on with your normal routine. When your permanent replacement teeth are ready, the temporary teeth are removed and replaced by permanent crowns or implant dentures.

What are potential problems after dental implant surgery?

As with any surgery, there is a small chance of infection following implant placement. This is the most common complication but is rare. Treatment may include antibiotics, gum grafting, or removal of the implants.

Other complications may include gum recession, loose implants, or nerve damage, although these are unlikely. If you have any of these symptoms, contact us to schedule a follow-up appointment so we can evaluate and treat the problem quickly.

Dental Implants Presentation

To provide you with a better understanding of dental implants, we have provided the following multimedia presentation. Many common questions pertaining to dental implants are discussed.

Dental Implants Presentation

When are the permanent replacement teeth attached to the implants?

With All-on-X dental implants, a temporary implant bridge is attached to the four to six implants in the jawbone, giving you a complete set of replacement teeth immediately. The permanent restorations are attached once the implants have successfully fused with the jawbone. Fusion usually takes 3-4 months.

How many implants will I need?

If you are missing a single tooth or just a few teeth, an individual implant will support each crown or restoration. If you have a full set of upper or lower teeth replaced, you will need between four and six implants to support the full arch of replacement teeth.

Is anesthesia used for dental implant surgery?

Most patients prefer to be sedated during dental implant surgery. In addition to numbing the area with a local anesthetic, your doctor may recommend nitrous oxide (laughing gas) to relax you during your procedure. This is a safe, effective form of sedation that relaxes you but does not render you unconscious. You will be able to hear and respond to your doctor, but you will not feel any pain or apprehension. Nitrous oxide takes effect quickly and wears off almost immediately.

What can I eat after dental implant surgery?

You are on a liquid diet for two days following surgery. On the third day, you can add soft foods such as mashed potatoes, hummus, steamed vegetables, peanut butter, and pudding to your diet. After a few weeks, you can add other foods with more texture, avoiding hard, crunchy, or sticky foods. Most individuals have returned to their normal diets within three to six months.

Questions about dental implant surgery are common. If you are interested in dental implants, we encourage you to schedule a consultation with Dr. Greenbaum. He will answer your questions and determine whether implant surgery is right for you. Contact our Bethesda, MD office Bethesda Office Phone Number 301-530-3600 for more information.